Cigar consumption has seen a significant and rapid rise in the United States in the past three to five years. Very little is known about the influence of cigar smoking on periodontal disease and tooth loss. In contrast, the detrimental effects of another tobacco product, cigarettes, on these oral outcomes are well established and knowledge of cigarette status helps the dentist decide on appropriate therapies for patients who smoke. It is hypothesized that cigar smokers should also be regarded as a high risk groups for periodontal disease. The aims of this proposed 3-year study are: (1) to describe the prevalence of clinical periodontal disease indicators in men who smoke cigars exclusively and compare them to men who never used tobacco products; (2) estimate the loss of alveolar bone mass that is attributable to cigar smoking independently of the rates of tooth loss over a two-year period in cigar smokers and nonsmokers. The subjects are 250 men aged 50 and older who are enrolled in one of three existing cohorts, the Normative Aging Study, The Dental Longitudinal Study, and the Veterans Health Study. All men in each cohort who currently smoke cigars (exclusive of other forms of tobacco use) will be invited to participate (n=125). A group of 125 men who never smoked will be selected, matching on age and study cohort. Each subject will undergo a baseline examination that includes 7 bitewing radiographs; measurements of tooth number, probing pocket depth, plaque, calculus, gingival assessment, clinical attachment loss, decay and restorations; and assessment by questionnaire of alcohol use, medical history, oral hygiene and dental utilization, and dietary intake. Interim changes in alcohol use, oral hygiene and dental utilization will be assessed by mailed questionnaires at 1 year. The examinations and questionnaires will be repeated two years later. Change in alveolar bone mass will be determined from the radiographs by digitized subtraction analysis. Analyses will be performed on baseline data to compare the prevalence of periodontal disease between cigar smokers and nonsmokers. In longitudinal analyses, rates of tooth loss, alveolar bone loss, and changes in clinical attachment loss and probing pocket depth will be compared between cigar smokers and non smokers to estimate the proportion of change in each that is attributable to cigar smoking.